The paper provides a literature review of different surgical procedures of extended organ-sparing and reconstructive treatment in patients with tumor involvement of the cotyloid cavity. The difficulties of early diagnosis and, as a result, the marked local extent of the process, the location of vital organs and great vascular and nervous structures in this anatomic area determine the technical complexity of surgical treatment in this cohort of patients. The cotyloid cavity or para-acetabular region is the most difficult pelvic ring area for reconstructive and organ-sparing surgery. The cotyloid cavity together with the femoral head forms the hip joint through which the pelvic ring is coupled with the lower extremity, ensuring that the hip bones are positioned horizontally, the torso and spinal column are vertically, and the lower extremities move relative to the torso. When the cotyloid cavity is completely removed without restoring the coupling of the femur and the pelvic ring, there is a change in the spatial position of pelvic bones and shortening of the lower limb that significantly loses its support ability and frequently becomes afunctional, which may give rise to chronic pain syndrome. As of now, the indications for organ-sparing surgical treatment for tumor involvement of the cotyloid cavity can be expanded due to the breakthrough and introduction of reconstructive plastic surgery into oncologic practice. In the past 40—50 years, a sufficient number of procedures to repair the cotyloid cavity after its resection for cancer have been developed and introduced into practice. All of them are characterized by the rather high frequency of complications and by ambiguous functional results after surgery. It is the opinion of most specialists engaged in reconstructive surgery for pelvic ring cancer that there is no universal procedure for reconstruction of the para-acetabular region in its tumor involvement now.